In cases where surgery is necessary, arthroscopy is the orthopedic gold standard. Dr. Mochizuki specializes in arthroscopy, a minimally-invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and disease through small incisions in the skin. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as MRI, CT Scan or X-rays.
During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the problem area, allowing the doctor to examine the joint in great detail.
Because it is minimally invasive, arthroscopy offers patients many benefits over traditional surgery:
- No cutting of muscles or tendons
- Less scarring
- Faster and more comfortable rehabilitation
- Less bleeding during surgery
- Smaller incisions
- Faster recovery and return to regular activities
Trauma or overuse can cause the shoulder’s soft tissues (ligaments, tendons, muscles and cartilage) to stretch or tear to the point where they can no longer provide the necessary support. A feeling of “looseness” may develop and the shoulder may “pop out” with some activities such as work, sports, or sleep.
Shoulder arthroscopy is performed under sterile conditions following an injection of a local anesthetic into the joint and/or general anesthesia.
A small incision is made to introduce a cannula with tubing attached. This tubing is connected to bags of saline used to irrigate and fill the joint space for better viewing. It also distends the joint space, allowing for easier passage of instruments. A second small incision is made to insert the arthroscope, which is attached to a camera and light source. These, in turn are attached to a video monitor to view and record the findings. Pictures may be taken and saved for later reference. A third incision may be made to introduce instruments for repair and to correct injuries. They may also correct tears and remove loose bodies.
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Elbow arthroscopy is generally used for simple manipulations of the joint. For instance, a patient with a compound fracture may have multiple fragments of the bone removed through arthroscopic surgery, but a replacement prosthetic most likely would not fit through a portal. It is also very useful for arthritis, as tools capable of debriding can be inserted and used to smooth out the problematic bone surfaces in a minimally invasive manner.
However, arthroscopy is not nearly as prevalent in elbow surgery as it is in other joint specialties such as the knee. This is because the small structure of the joint requires very specialized training so the surgeon does not disturb the multiple nerves crossing the joint. This forms an inherent risk in any procedure in the elbow, but more so in arthroscopy due to its nature of camera insertion.
Wrist arthroscopy is a minimally invasive surgical procedure that can be used to both diagnose and treat a wide range of conditions affecting the wrist joint. The wrist is made up of eight small bones, along with ligaments, tendons and other tissues that can become damaged as a result of degeneration, trauma, disease and other factors.
During the procedure, your surgeon will make several tiny incisions in the wrist, into which an arthroscope and small surgical instruments are inserted.
Depending on what is found during the diagnostic procedure, your surgeon may choose to treat the condition at the same time. Wrist arthroscopy can be used to remove inflamed areas, repair fractures, remove ganglion cysts and repair torn ligaments or tendons.
Knee injuries that are frequently treated using arthroscopic techniques include meniscal tears, mild arthritis, loose bone or cartilage, ACL and PCL tears, synovitis (swelling of the joint lining) and patellar (knee cap) misalignment.
Anterior cruciate ligament tears, chondral injuries and meniscal tears that can not be treated with rest, physical therapy and medication can usually be treated by arthroscopic surgery techniques. Arthroscopic knee surgery provides a more rapid, less painful and more complete rehabilitation from sports injuries than from traditional open surgical procedures.
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